VitalStim

Help for Patients With Oropharyngeal Dysphagia

Until VitalStim® Therapy, little or no curative techniques were available for treatment of dysphagia. Today, your patients can get help at HealthSouth Deaconess Rehabilitation Hospital.
For more information about VitalStim Therapy, contact Judy Kissel, HealthSouth Speech Therapist, at 812/476-9983.

What Is VitalStim® Therapy?

VitalStim® Therapy is a neuromuscular electrical stimulation (NMES) technology. It is the only NMES cleared by the FDA to restore swallowing function to patients with oropharyngeal dysphagia. It is a non-invasive way to re-educate the throat muscles needed for swallowing.

In clinical and real-world settings, VitalStim Therapy has been proven safe and effective. It has successfully treated patients of every age and etiology, even those whose dysphagia has advanced beyond the six-month period of spontaneous recovery.

Treatment at HealthSouth Deaconess

Physician referral is required. Upon referral, our clinicians will perform a medical evaluation. In appropriate patients, a certified VitalStim Therapy professional will provide therapy. Therapists must be certified after a 2-day training seminar and have 3 years experience treating dysphagia patients.

Therapists deliver VitalStim Therapy using uniquely designed external skin electrodes. They place the electrodes on specific neck muscles in a fully validated pattern. The electrical current emitted by the VitalStim device stimulates inactive or atrophied swallowing muscles as the therapist administers rehabilitation therapy to help re-educate the muscles. For example, patients practice eating and perform exercises under the direction of the therapist.

Therapy sessions last 60 minutes and are repeated daily (or almost every day) until the patient’s swallowing patterns are restored to the optimum level. Patients frequently see dramatic improvement in six to 20 daily sessions – sometimes in as little as three days.

The FDA Study: Efficacy & Safety

VitalStim Therapy’s clearance by the FDA (in December 2002) was based on a long-term study of nearly 900 patients, both inpatient and outpatient, which included direct comparison of electrical stimulation using VitalStim Therapy with thermal stimulation, a common approach to treating dysphagia. Based on this study, electrical stimulation proved to be significantly more effective in restoring swallowing function. Measurable improvement was noted in over 98% of patients studied, compared with less than 33% of the patients receiving thermal stimulation.

VitalStim® Therapy FACT SHEET

In patients with severe dysphagia, VitalStim Therapy’s success rate in restoring patients’ swallowing function past the point of their requiring a feeding tube (Percutaneous Endoscopic Gastrostomy or PEG) was 97.5%, versus 39% for thermal application.

Further, in well over one-third of these severe dysphagia cases, VitalStim Therapy was able to restore the patient’s swallowing function completely, while not a single patient was restored to full function by means of thermal application.

VitalStim Therapy was effective independently of the cause of a patient’s dysphagia, including such common causes as stroke, head or neck cancer, degenerative neurological conditions (e.g., Parkinson’s Disease, Multiple Sclerosis), and respiratory conditions.

VitalStim Therapy proved effective across the full spectrum of age groups and in both sexes. The success rate in patients over 80 years old was comparable to that in patients 51-80 years old, as was the success rate in children aged 1-4, and even in infants.

VitalStim Therapy was also effective independently of any other health problems that were unrelated to patients’ dysphagia, such as diabetes, hypertension, coronary artery disease or chronic obstructive pulmonary disease (COPD).

VitalStim Therapy’s effectiveness was independent of the time between the onset of dysphagia and treatment. It was just as effective in patients who had suffered from dysphagia for over 6 months as in those who had only recently developed the condition.

The study also showed that VitalStim Therapy is a safe application of electrical stimulation. Over 4,500 stimulations were administered to nearly 900 patients without negative side effects like laryngospasms or changes in heart rhythms or blood pressure; no problems were observed in patients who had pacemakers.

The lasting effectiveness of VitalStim Therapy was demonstrated in a 3-year follow-up study (submitted to the FDA), which showed that the improvement in swallow function achieved by this therapy persisted for up to 3 years after treatment, and that the superior results of electrical stimulation over thermal stimulation are maintained long-term.

Why Your Dysphagic Patients Need VitalStim

Avoidable Deaths - Dysphagia often has devastating consequences. Each year, according to the Agency for Health Care Policy and Research (AHCPR), over 60,000 Americans die from complications associated with swallowing dysfunctions, most commonly aspiration pneumonia.

Other Physical Complications - In addition to aspiration pneumonia, dysphagia also predisposes patients to complications such as choking, bronchospasm, increased infection rate, chronic malnutrition, severe life-threatening dehydration, significant weight loss, muscle wasting, physical debilitation, and death from asphyxia. In head and neck cancer patients, dysphagia can also lead to poor wound healing and reduced tolerance to medical treatments.

Quality of Life Issues - Dysphagia profoundly affects quality of life. Dysphagic patients experience personal discomfort and a drastic reduction in the quality of their lifestyles due to the inconvenience and pain of feeding tubes, which has been a primary treatment option. The loss of swallowing can also lead to severe depression due to the interruption of patients’ normal ways of life.

Healthcare Costs - Complications due to dysphagia also increase healthcare costs by resultant hospital readmissions, emergency room visits, extended hospital stays, the necessity for long-term institutional care, and the need for expensive respiratory and nutritional support. For the most severe cases, a tracheostomy for breathing and percutaneous endoscopic gastrostomy (PEG) tube for nutritional supplements are typical.